Clinical Skills Lab: Foley Catheterization and Medical Examinations by Daryl P. Lofaso
Explore the detailed procedures for Foley catheterization, breast, testicular, pelvic, and rectal examinations as outlined by Daryl P. Lofaso, M.Ed, RRT. Learn about urethral catheterization indications, anatomical landmarks, and hand positions for both male and female catheterization. Discover the importance of pelvic and breast examinations, along with statistics on breast cancer. Gain insights into nosocomial UTIs and the indications for rectal examinations.
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Presentation Transcript
CSI 202 Skills Lab 6 GU (Foley) Catheterization, Breast, Testicular, Pelvic & Rectal Examinations Daryl P. Lofaso, M.Ed, RRT
Urethral Catheterization Indications Long Term Refractory bladder outlet obstruction Neurogenic bladder with urinary retention Complications of incontinence Skin breakdown Terminally ill Short Term Urologic or pelvic surgery Acute urinary retention Urinary output monitoring in critically ill
Anatomic Landmark for Female Catheterization
Female Cath: Hand positions
Male Catheterization Uncircumcised male -pull foreskin back Visualize the meatus Maintain hand position throughout procedure
Nosocomial UTI 80% associated w/urinary catheters Common Organisms E. coli Enterococcus species* Pseudomonas aeruginosa* Candida albicans * Antibiotic resistance may lead to increased morbidity
Pelvic Examination Indications: Physical Exam Abdominal pain Pelvic pain Yearly screening (pap smear)
Breast Examination Indications: Physical Exam Breast Pain Lumps Breast Development- adolescent
Breast CA NCI recommends mammograms every 1- 2 years at 40 years of age Mammograms yearly at age 50 Mammograms as early as 25 yrs of age for pt. with high risk of breast CA Studies suggest Breast CA could be cut by 36-44% if mammography performed annually
Breast CA - Statistics In 2008 210,203 women in the US were diagnosed with breast cancer 40,589 women in the US died from breast cancer
Rectal Examination Indications: Physical Exam Abdominal pain Rectal pain Urogenital dysfunction (complaints) Screening for Colon CA and Prostate CA
Charting: Rectal Examination Tone normal, decrease or absent Masses Stool color, Hemoccult examination of stool Prostate size, texture
Prostate CA Prostate Cancer: 6.62% of men who are now 60yrs old will get prostate CA Approx. 3.6% of all deaths of American men caused by Prostate CA Only 3 men in 100 will actually die of it Family History - risk African American men: very high risk High fat diet associated with risk
Testicular Examination Indications: Physical Exam Urologential dysfunction (complaints)
Testicular CA Incidence of testicular cancer is low, 4 per 100,000 Most common cancer between the ages 20-34 yrs Second most common 35-39 yrs Third most common 15-19 yrs Common among white men Testicular Self-examination (TSE)
Professional Conduct Introduce yourself Explain the procedure/exam to pt. Ask pt. if they have any questions Cover pt. with a sheet. Only expose area which you are examining, then cover again While performing the procedure/exam, explain to the pt., you may or may not be some discomfort associated with the exam, but you will be as gentle as possible.
